The International Nursing Association for Clinical Simulation and Learning (INACSL )

1. The International Nursing Association for Clinical Simulation and Learning (INACSL) 2011 Standards of Best Practice: Simulation Pearson Faculty Development March 23, 2012 Fort Lauderdale

2. Presenters and Disclosures • Laura Gonzalez PhD, ARNP, CNE • INACSL Chair of Education • Assistant Professor of Nursing, University of Central Florida • Disclosure: Pearson Faculty Consultant & Contributor Pearson Faculty Development March 23, 2012 Fort Lauderdale

3. Mission and Vision Statements • The Mission of INACSL is to promote research and disseminate evidence based practice standards for clinical simulation methodologies and learning environments • The Vision Statement: Nursing’s portal to the world of clinical simulation pedagogy and learning environments Pearson Faculty Development March 23, 2012 Fort Lauderdale

4. Development of Standards • 2 Years • Survey to INACSL Membership • Committee Draft • Peer Review • Final Draft • Publication – Summer 2011 Pearson Faculty Development March 23, 2012 Fort Lauderdale

5. Special Thanks to the 2009-2011 INACSL BOD • Teri Boese, MSN, RN • Jimmie Borum, MSN, RN • Janis Childs, PhD, RN • Sharon Decker, PhD, RN, ANEF • Jana Faragher, ND, CNS, RN • Cheryl Feken, MSN, RN • Teresa Gore, DNP, APRN • Nicole Harder, PhD, MPA, RN • Beverly Hewett, PhD, RN • Valerie Howard, EdD, RN • Kim Leighton, PhD, CNE, RN • Colleen Meakim, MSN, RN • Meg Meccariello, MS, RN • Patricia Ravert, PhD, RN, CNE, ANEF • Leland (Rocky) Rockstraw, PhD, RN • Carol Sando, PhD, CNE, RN • Renee Schnieder, MSN, RN • Marianne Schubert, MSN-Ed, CEN, MICP, RN Pearson Faculty Development March 23, 2012 Fort Lauderdale

6. Special Thanks • Standards Committee 2010-2011 for their continued work on revisions and peer-review process • Jana Faragher, ND, CNS, RN-Chair • Sharon Decker, PhD, RN, ANEF • Teri Boese, MSN, RN • Carol Sando, PhD, RN, CNE Pearson Faculty Development March 23, 2012 Fort Lauderdale

7. Standards of Best Practice • Terminology • Professional Integrity of Participant • Participant Objectives • Facilitation Methods • Simulation Facilitator • The Debriefing Process • Evaluation of Expected Outcomes INACSL Board of Directors, (August, 2011). Standards of best practice: Simulation. Clinical Simulation in Nursing, 7(4 Supplement). S1-S20. Available at http://www.nursingsimulation.org/issues?issue_key=S1876-1399(11)X0005-1 Pearson Faculty Development March 23, 2012 Fort Lauderdale

8. Standard One: Terminology Statement: Consistent terminology provides guidance, clear communication, and reflects shared values in simulation experiences, research, and publications. Pearson Faculty Development March 23, 2012 Fort Lauderdale

9. Rationale • Standardized terminology: • Enhances understanding and communication among planners, participants and others involved in simulation experiences • Promotes consistency in the development, implementation, evaluation and publication of or about simulated clinical experiences or research studies for use in education and practice Pearson Faculty Development March 23, 2012 Fort Lauderdale

10. Nursing Skill Development & Judgment Model Pearson Faculty Development March 23, 2012 Fort Lauderdale

11. Standard Two: Professional Integrity of Participants Statement: The simulation learning and testing environment will be one of clear expectations for the attitudes and behavior of each participant and an area where mutual respect is supported. Professional integrity related to confidentiality of the performances, scenario content, and participant experience is expected to be upheld during a simulation experience. These performances in simulation experience may be live, recorded, and/or virtual. Pearson Faculty Development March 23, 2012 Fort Lauderdale

12. Rationale • Failure of the participants to maintain professional integrity related to simulation and lack of respect or professionalism could undermine the benefits of this pedagogy • Sharing of confidential information of any kind before, during or after the simulation experience can alter the experience Pearson Faculty Development March 23, 2012 Fort Lauderdale

13. Outcomes • This standard offers the opportunity for similar learning experiences to all participants • Upholding professional integrity promotes a safe learning environment • To achieve the desired outcomes, the facilitator must address key areas during the simulation Pearson Faculty Development March 23, 2012 Fort Lauderdale

14. Standard Three: Participant Objectives Statement: The simulation experience should focus on the participant objectives and experience level. Pearson Faculty Development March 23, 2012 Fort Lauderdale

15. Rationale • Participant objectives are the guiding tools for simulation and essential to achieve the outcomes • Identification of appropriate scenario, fidelity, instructor prompting/facilitating, and environment is crucial for best experiences and meeting the participant objectives Pearson Faculty Development March 23, 2012 Fort Lauderdale

16. Outcomes • The focus of simulation is on the outcome to be achieved and on participant learning-Know your participants • Should facilitate the development of clinical judgment in order to deliver high quality and safe nursing care that is holistic and includes cultural awareness Pearson Faculty Development March 23, 2012 Fort Lauderdale

17. Standard Four: Facilitation Methods Statement: Multiple methods of facilitation are available, and use of a specific method is dependent upon the learning needs of the participant(s) and the expected outcomes. Pearson Faculty Development March 23, 2012 Fort Lauderdale

18. Rationale • Facilitation methodology should vary because participants bring cultural and individual differences that affect their knowledge, skills, attitudes (KSAs), and behavior • Facilitation assists the learner to meet the objectives by incorporating learner’s needs and experience into the planning and implementation of a simulated clinical experience Pearson Faculty Development March 23, 2012 Fort Lauderdale

19. Outcomes • Facilitation revolves around engaging participants within the scenario by assisting them to meet the objectives of the clinical scenario • Effective facilitation requires using the facilitation method and personnel/faculty indicated by participant objectives and expected outcomes Pearson Faculty Development March 23, 2012 Fort Lauderdale

20. Standard Five: Simulation Facilitator Statement: A proficient facilitator is required to manage the complexity of all aspects of simulation. Pearson Faculty Development March 23, 2012 Fort Lauderdale

21. Rationale • The facilitator is the key to participant learning: • guides and supports participants to understand and achieve the objectives • Engages the participants to search for evidence-based practice solutions to develop participant’s skill development and clinical judgment • Adjusts simulations to meet objectives based on participant’s actions or lack of actions • Leads the participants in identifying the positive actions and changes Pearson Faculty Development March 23, 2012 Fort Lauderdale

22. Outcomes • Facilitator promotes and assists with achieving the desired outcomes of a simulated experience by utilizing various methods Pearson Faculty Development March 23, 2012 Fort Lauderdale

23. Standard Six: The Debriefing Process Statement: All simulated experiences should include a planned debriefing session aimed toward promoting reflective thinking. Pearson Faculty Development March 23, 2012 Fort Lauderdale

24. Rationale • Learning is dependent upon the integration of experience and reflection • Reflection is the conscious consideration of the meaning and implication of an action • The skills of the debriefer are important to ensure the best possible learning • Learners report the debriefing session is the most important component of a simulated learning experience Pearson Faculty Development March 23, 2012 Fort Lauderdale

25. Outcomes • The integration of the process of debriefing into simulation: • Enhances learning • Heightens self-confidence for the learner • Increases understanding • Promotes knowledge transfer • Identifies best practices • Promotes safe, quality patient care • Promotes life-long learning Pearson Faculty Development March 23, 2012 Fort Lauderdale

26. Outcomes (Continued) • To achieve the desired outcomes, the effective debriefing process should: • Be facilitated by individual competent in debriefing that observed the simulation • Use evidence-based debriefing methodologies • Be based on a structured framework for debriefing • Be based on objectives, the learners, & the outcomes • Be conducted in an environment that supports confidentiality, trust, open communication, self-analysis & reflection Pearson Faculty Development March 23, 2012 Fort Lauderdale

27. Standard Seven: Evaluation of Expected Outcomes Statement: This standard addresses summative evaluation as opposed to formative assessment. Pearson Faculty Development March 23, 2012 Fort Lauderdale

28. Rationale • Simulation is an acceptable method of evaluating the three domains of learning: • Cognitive (knowledge) • Affective (attitude) • Psychomotor (skills) Pearson Faculty Development March 23, 2012 Fort Lauderdale

29. Outcomes • The participant’s achievement of expected outcomes of a simulation experience should be based on valid and reliable instrumentation, tools, and methodologies in the evaluation process • To achieve valid and reliable evaluation results, the simulation used for the purpose of assessment and particularly high-stakes evaluation must follow certain aspects. Pearson Faculty Development March 23, 2012 Fort Lauderdale

30. Resources • International Nursing Association for Clinical Simulation and Learning (INACSL): http://www.inacsl.org/INACSL_2010/ • Society for Simulation in Healthcare (SSH): http://www.ssih.org/SSIH/ssih/Home/ • Simulation Innovation Resource Center (SIRC) http://sirc.nln.org/ • METI: Human Patient Simulation Network (HPSN) http://www.hspn.com/ • Laerdal: Simulation User Network (SUN) http://simulation.laerdal.com/ Pearson Faculty Development March 23, 2012 Fort Lauderdale

31. Evaluation Tools • Kardong-Edgren, S., Adamson, K. A., & Fitzgerald, C. (2010, January). A review of currently published evaluation instruments for human patient simulation. Clinical Simulation in Nursing, VOL(6), e25-e35. doi:10.1016/j.ecns.2009.08.004 • METI Simulation Effectiveness Tool and Educational Material • http://www.meti.com/mymeti/education_main.html • NLN and Laerdal Simulation Study Evaluation Tools • http://www.nln.org/research/toolsandinstruments.htm • Other tools are available Pearson Faculty Development March 23, 2012 Fort Lauderdale

32. What Can I Do With the Standards? • Curricular Integration • Evidence Based Practice in Education • Administrative Support • Faculty Buy-In • Research Opportunities • Funding Opportunities Pearson Faculty Development March 23, 2012 Fort Lauderdale

33. INACSL Conference 11th Annual International Nursing Simulation/Learning Resource Centers Conference: Saddle up for Simulation: Rope in the Best Ideas Pre-conference: June 20, 2012 Conference: June 21 -23 2012 San Antonio Marriott Rivercenter Pearson Faculty Development March 23, 2012 Fort Lauderdale

34. How to Obtain Standards of Best Practice: Simulation • Initial publication of the Supplement to Clinical Simulation in Nursing was made possible by an educational grant from METI • Will be printed and mailed to current members of INACSL • Available through the official journal of INACSL: Clinical Simulation in Nursing http://www.nursingsimulation.org/ • Journal access is just one benefit of membership in INACSL Pearson Faculty Development March 23, 2012 Fort Lauderdale

35. Conclusion • Thank you for attending this presentation • Question and Answer Session Pearson Faculty Development March 23, 2012 Fort Lauderdale